The Patient Protection and Affordable Care Act (ACA)

Providing More Community-Based Care

What This Is

The ACA addresses long-term care services to help guarantee that individuals who need such care receive it and to find ways to help make such care available not only in institutions but also in the community (ACA, 2010, §2406(b)1-2). Some examples include:

Community First Choice Option
The program offers incentives through Medicaid to encourage states to provide programs that help seniors stay at home rather than enter an institution.

Money Follows the Person (MFP)
Extended for 5 years, this approach helps states develop demonstration projects that allow them to make changes to long-term care strategies and help people avoid institutions altogether or transition from institutions to their communities.

What This Means for SLPs and Audiologists

Most community-based care programs are designed to encourage primary care practitioners to provide in-home care and attendant services that help patients to periodically leave long-term facilities. Primary care practitioners include primary care physicians, nurse practitioners, and physician assistants.

However, states will determine models for care coordination; as interdisciplinary teams are established, speech-language pathologists (SLPs) and audiologists may have additional opportunities to provide services in the home. As many of these programs begin to expand, SLPs and audiologists may have more opportunities to contact program administrators about joining interdisciplinary teams.

Implementation Time Line

Implementation is an ongoing process, as the Center for Medicare and Medicaid Innovation (CMMI) and Centers for Medicare and Medicaid Services (CMS) Disabled and Elderly Health Programs Group continue to issue program announcements and updates. Many demonstration programs have been scheduled for mid-2011 and mid-2012 through 2015.

ASHA's Role

ASHA continues to monitor new programs and opportunities for speech-language pathology and audiology services to be included in program offerings, when possible.

Additional Resources

Center for Medicare & Medicaid Innovation Partnership for Patients Program

ASHA Corporate Partners